Understanding Improvements in Disparities in Breast Cancer Care in Memphis,Tennessee: A Comparison of Two Time Cohorts

Abstract

Introduction

Between 2005 and 2009, Black women in Memphis had the highest breast cancer mortality rate in the United States as compared to their White counterparts. This study assesses current breast cancer outcomes for Black women in Memphis with hopes of finding improvement.

Methods

Patients with breast cancer were identified in the tumor registry of a large health care system in Memphis, TN. Patients were stratified by race. Associations between race, clinical characteristics, and treatments were determined using chi-square tests. Associations between race, recurrence, and mortality were determined using logistic regression. The study sample was divided into period 1 (2002-2012) and period 2 (2013-2020) for comparison.

Results

In period 2, 36.5% of Black women and 48.8% of White women presented with stage 1 disease (P < 0.001). 11.4% less Black women were diagnosed with stage 2-4 disease in period 2 as compared to period 1. Treatment regimens are stratified per race in Table 1. In both periods, the median time to surgery (TTS) was higher for Black vs White women with stages 0-3 disease. In period 2, Black women were 42% more likely to experience recurrence and 36% more likely to die when compared to White women vs findings in period 1 of 100% and 50%, respectively (P < 0.05).

Conclusion

Albeit improved over the past decade, there continues to be significant racial disparity in breast cancer treatment in Memphis. Our next steps will be to evaluate specific social and medical interventions currently existing while identifying areas for improvement.